HCC 387: Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders ICD-10-CM
CMS-HCC Category 387 (Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.125 and 0.658 to a beneficiary's RAF score depending on the payment segment (0.406 for a community, non-dual, aged enrollee). 14 ICD-10-CM diagnosis codes map to HCC 387. It sits at the top of its hierarchy: no other condition category supersedes it.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.406 |
| Community, partial-benefit dual, aged | 0.477 |
| Community, full-benefit dual, aged | 0.658 |
| Community, non-dual, disabled | 0.302 |
| Community, partial-benefit dual, disabled | 0.498 |
| Community, full-benefit dual, disabled | 0.622 |
| Institutional | 0.125 |
A beneficiary is scored in exactly one segment, set by Medicaid (dual) status, aged or disabled entitlement, and residence. Factors are relative weights, not dollar amounts; new-enrollee segments score on demographics only. HCC 387 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.
ICD-10-CM Codes That Map to HCC 387 14 codes
- D86.3 Sarcoidosis of skin new to V28
- L10.0 Pemphigus vulgaris new to V28
- L10.1 Pemphigus vegetans new to V28
- L10.2 Pemphigus foliaceous new to V28
- L10.3 Brazilian pemphigus [fogo selvagem] new to V28
- L10.4 Pemphigus erythematosus new to V28
- L10.81 Paraneoplastic pemphigus new to V28
- L10.89 Other pemphigus new to V28
- L10.9 Pemphigus, unspecified new to V28
- L12.0 Bullous pemphigoid new to V28
- L12.1 Cicatricial pemphigoid new to V28
- L12.8 Other pemphigoid new to V28
- L12.9 Pemphigoid, unspecified new to V28
- L88 Pyoderma gangrenosum new to V28
Every code above carries the full HCC 387 weight when documented and reported on a Medicare Advantage encounter. The code link opens its full page with the complete risk adjustment card.
Questions About HCC 387
What is HCC 387 in the CMS-HCC model?
HCC 387 is CMS-HCC Category 387 (Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders) in the V28 risk adjustment model. It covers 14 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 387?
For payment year 2026, HCC 387 adds 0.406 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.125 to 0.658 across the seven payment segments shown above.
Related References
Source: Centers for Medicare & Medicaid Services, Payment Year 2026 risk adjustment mapping and model software releases (CMS-HCC V28), applied to the FY 2026 ICD-10-CM code set. ICD List is not affiliated with CMS.
